CHARLOTTE O’BRIEN on How Not to Die During Childbirth

I didn’t know I was dying. These days, women don’t typically die during childbirth. I’d read all the books, taken all the classes and studiously boned up for the zen-like delivery I had planned in the birthing center that I’d carefully chosen for its midwives and lactation support. Instead, I lay in a hospital bed dying, engulfed by pain, unable to will myself back from the dim place where I was only barely aware of my husband and older daughter standing beside me. Every two minutes my body involuntarily lurched forward in an effort to expel my baby’s body. With each surge, I let out a guttural wail and then flopped back into half-consciousness. Someone rolled me to my side. Someone held oxygen to my face. Someone else held my hand. The hand felt cool but soothing like I was anchored to it.

My partner has since told me that at this point the midwife and the anesthesiologist stepped into the hall to argue about what they should do, which was when he became really worried. I heard the machines I was hooked up to erupt in a frenzy of beeping and someone far off in the distance, presumably a nurse, shouted

“I need someone in here now! Her BP is ninety over sixty.” The midwife must have returned to the room because at some point I heard her snap,

“Turn off that machine. It’s not helping.” And then there was silence.

It was a text-book case for everything that could go wrong during childbirth. After hours of back labor with a posterior facing baby, I’d finally requested an epidural. Now, the baby was in distress. The epidural hadn’t taken and my blood pressure had plummeted. All of my birthing books warned me about epidurals, but an epidural was the Ace I’d been secretly holding. During childbirth the first time around, when my body had tensed up and refused to cooperate, an epidural had served to relax my body enough that within an hour of being given the anesthesia, my first daughter, Mia was born. This time, when the birth plan, the candles, the visualizations, the hot tub, the massage, the rocking, and the midwife who gripped my shoulders and asserted “You can do this,” all failed to get me past a discouraging three centimeters, when the baby was still at zero station having not descended into the birth canal even a fraction. I played my Ace.

“Epidural,” I said. “I want an epidural.” When, after several more searing contractions, the anesthesiologist still hadn’t arrived. I cried real tears and yelled,

“I want an Epidural!”

When I became pregnant with my second daughter, I was working in a center for pregnant and newly postpartum moms. I saw women from every spectrum walk through our doors. Some women scheduled their C-sections, sometimes as early as thirty-four weeks. Others had standard hospital births, while others had home births in birthing tubs in their living rooms. I was surrounded by lactation specialists and doulas and a library of books and DVD’s on everything from natural childbirth to sleep solutions for newborns. I’d read my Ina May Gaskin who back in the sixties had pioneered intervention free childbirth. I watched the entire catalogue of DVDs in our library, including one titled, “Orgasmic Birth,” and devoured all the “How to” articles such as “How to have a Stress-Free Birthing Experience.”

I gave birth to Mia at the drastically ill-equipped age of twenty-one. It was twelve years before I became pregnant with my second child. At thirty-eight, I still felt young and vibrant. I wasn’t concerned; I was ready to have the perfect birthing experience. Being the parent of a twelve-year-old should have alerted me to the fact that when it comes to children and childbirth, there is no such thing as a perfect scenario. Parenthood means you cannot count on anything, except for the fact that nothing will go according to plan. Intellectually, I knew this. Friends and colleagues had warned me that my birth plans might not live up to my expectation. I ignored all their well-intentioned advice. I put my first birthing experience, replete with a pitocin-induced labor, a morphine-induced haze, and an epidural as the grand finale, down to inexperience and a lack of conviction.

I wasn’t able to afford a doula or a homebirth midwife as my insurance, like most, wouldn’t spring for something they consider New Agey. My Ob/Gyn was just fine. Her practice was reputable and she was pleasant and efficient. She seemed genuinely happy for me when we saw my daughter’s tiny spine curled inside me like a seahorse and her heart furiously beating away during the first sonogram at twelve weeks. Then something happened during my twenty week prenatal screening.

A somber white-coated doctor ushered me from the sonogram room into a genetic counselor’s office where the term Down syndrome was used and I was asked if I planned to terminate my pregnancy should they find any abnormalities. I was then urged to immediately undergo an amniocentesis. While I sobbed uncontrollably, my partner asked what the exact percentages were. We discovered the odds of having a miscarriage after amniocentesis were higher than me having a baby born with Down syndrome. Without further ado, we left that place, never to return.

I immediately switched my Ob/Gyn for a clinic staffed mostly by midwives. I also changed my birth location from a big hospital with medical intervention practices to a small hospital that was much like a birthing center. This birthing center-esq hospital had a whirlpool in each room. During my tour, the head administrator stopped to shake my hand and tell me about the champagne dinner they served couples the night after they had their baby. We walked down a quiet corridor past the rooms where they performed C-sections. Our tour guide waived her hand dismissively.

“We don’t do those often,” she said.

A month before I gave birth to my daughter, my friend, Kate, had given birth via C-section to her baby boy. Her doctor worked out of a prestigious hospital and had a reputation for being the best in town. The doctor was well known to me and the staff where I worked. We called her the C-Section doctor. Almost all of her patients who came to see us were mysteriously scheduled for or given emergency C-sections. As it turned out, my friend Kate had placenta previa. There was no safe way to deliver her child without a C-section. But after twenty weeks, my friend’s placenta shifted upwards and her doctor told her she could attempt a vaginal delivery. On the day, however, after many hours of labor, Kate was taken to the operating room for an emergency C-section. The minute her boy came out, he was handed to her husband. Father and son were whisked to the nursery after which Kate’s doctor worked for two hours to stop her from bleeding out on the operating table. Kate’s uterus had ruptured and she’d suffered massive internal bleeding. Had she delivered vaginally, the cause of the bleeding would not have been found as quickly and Kate would have most likely died.

This story flickered in the back of my mind as I entered the hospital ten days overdue, ready, a second time, to be induced. We passed the operating rooms down the hall from the birthing rooms. There was no ICU and no NICU. If anything serious happened to me or baby, we would have to be transported to the big hospital in the next town. But I wasn’t worried. I was armed with electric tea lights, massage oil, Gatorade, a birth plan, and a birthing visualization—a drawing I had made of a woman sitting in the lotus position, smiling, with a baby crowning from her vagina and a rainbow above her head.

After the silence, I remember the anesthesiologist shaking me. He was trying to rouse me from my low blood pressure induced stupor. I remember feeling irritated by this. Didn’t he know I was busy trying to give birth?

“Charlotte,” he said, “It’s important you focus. Can you feel this?” He rolled a tiny silver wheel across my leg. I watched something dull and cold like a tiny pizza cutter roll across my thigh. I couldn’t distinguish the knowledge of the wheel on my leg from the feeling of the wheel on my leg. He repeated the action several times, but I couldn’t give him an answer. He shook me again. He couldn’t help me unless I answered him. Another surge of pain wracked my body. Someone squeezed my hand. I turned my head to see that it was Mia who was holding my hand. Of course, I thought. It seemed appropriate that my daughter should be the person anchoring me to the room.

Just then, the door swung open and a composed man carrying a messenger bag walked in. He exuded warmth and confidence. My partner says the atmosphere of the room changed instantly.

“What’s happening?” asked the man. He leaned in to shake my partner’s hand. The midwife rattled off my statistics. She stood back from my bed near the door, allowing him his space. I noticed with abstract curiosity that she looked shaken. Perhaps it was the surprise of his entrance, or perhaps it was at this exact moment that the medicine started working. I felt myself slowly return to my surroundings.

“Did you draw this?” the man asked my daughter. I followed his gesture to the visualization drawings stuck to the cabinets facing my bed. My daughter had drawn one, too. The lotus lady smiled down at me. I felt like an idiot.

“Yes,” said my daughter. I could tell by her voice that she was scared. He continued to talk to her while he snapped on his rubber gloves and examined me.

And here is the part of the story that defied all of my plans and expectations. The miracle of being able to grow a human inside your body is just that: a miracle. Birth is messy and unpredictable and sometimes dangerous. In the several years it has taken me to recover from the disappointment of not being able to have the perfect birth experience, I’ve realized something: midwives and home births aren’t always better than Ob/Gyns or hospitals, and, sometimes, interventions are necessary. There isn’t one best solution for the painful, emotional process of delivering life into the world. Each person and each situation comes with its own unique set of circumstances.

The doctor who was on call that night just happened to be a man and the chief surgeon at the Ob/Gyn practice I’d so carefully chosen for its midwives. He didn’t rush me into an operating room and gleefully cut me open the way I’d presumed all obstetric surgeons would. Instead, he did something that, inexplicably, my midwife wasn’t trained to do, (and it occurs to me now, had I not been loaded to the gills with anesthesia, he wouldn’t have been able to do it,) he reached inside me and turned the baby.

With my contractions magically alleviated and my blood pressure back to normal, my cervix completely dilated and the baby now fully descended into the birth canal, I sat up and pushed her out.

My oldest daughter cried noisy tears while my newest one squirmed on my chest with her mouth open like a baby bird waiting to be fed. We were alive. My partner leaned over to kiss me. He’s since said that for several hours after our daughter’s birth his relief overshadowed his ability to enjoy our newborn. Later, he lay with her skin to skin while I slept. This was when he felt a bond form between them, the bond of parent to child: imperfect and miraculous.

About the Author

Charlotte O’Brien is a San Francisco Bay Area writer with essays and interviews most recently published in The Rumpus, Mutha Magazine, and The Manifest-Station. She graduated from Pacific University’s MFA program in 2013. Charlotte lives with her teenager, her five year old, and a scruffy dog. She is currently writing a memoir about living in America as an undocumented immigrant. You can find out more about her at www.charlotteobrien.org.

I’m a busy birth doula who just supported a client through a c-section last night, my first in about 20 months. It’s so good to read an honest birth story that neither idolizes nor villifies midwifery or highly medicalized birth, but rather discusses the beautiful things that can happen when midwives and OB/GYNs work nicely together. Thank you for your candor, and congratulations on the birth of your baby!

Yes we did and although I wish Id had a doula, I will say that the nurses were amazing. I was ultimately very happy with the hospital. They were very accommodating and (per my request) kept baby in the room with me for all her procedures directly after birth instead of taking her to the nursery.

We worked with a midwife, the only one for hundreds of miles so we had no choice. I wanted a water birth at her clinic. The clinic had to close on my due date because of some compliance issue. It was then that we should of just looked for an obgyn to work with. Instead we stayed with the midwife and ended up being transferred to an ER at 4am an hour away after 30 hours of labor. I had my c-section, my baby was born over 41 weeks close to 42. It wasn’t an emergency c-section, I labored six more hours at the hospital, so I had time to {try} to “think” and make decisions I wanted to make. Not all midwives are the same, there are some bad ones, inexperienced ones. Mine lacked experience. In the end I was happy to be at a hospital and face the c-section I had read was so terrible. It wasn’t bad at all and I breastfed 3.5 years. I had read that breastfeeding was negatively affected by c-sections. I read a lot of things.

Hi Tera, sorry I only just saw your message. I agree that there can be inexperienced midwifes. I’m still unclear whether my midwife was inexperienced or whether she was restricted by the hospital on what she could or couldn’t do. If I were to do it again I would probably fork out the money to hire a private, experienced midwife or alternatively go to a midwife based birthing enter, But, as we know, no matter how prepared we are, there’s no way to predict outcome. Thanks so much for sharing your story.4

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